Online Application Form

Select Title (required)
---MrMrsMissMs

Your Full Name (required)

Your Email (required)

Mobile Phone:

Home Phone:

Full Address including postcode:

Date of Birth
12345678910111213141516171819202122232425262728293031 / JanFebMarAprMayJunJulAugSepOctNovDec / 20162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901

Membership Type (required)
First Claim - £34Second Claim - £20Social - £15

First Name Club (if other than Kippax)

Payment Method (required)
Bank Transfer (please see bank details below and make sure, your name is referenced)

Emergency Contact

Emergency Contact Telephone Number

Where Did You Hear About Us:

Declaration

I certify that the above information is true and correct to the best of my knowledge.
I understand that membership is voluntary and at my own risk.
I agree to abide by the rules and constitution of the club.
I agree to the information I have provided being stored on the club database, shared with other club members and for membership purposes.

Privacy Notice
Kippax & District Harriers are committed to protecting and respecting your privacy. For any personal data you provide for the purposes of your membership, Kippax & District Harriers is the Data Controller and is responsible for storing and otherwise processing that data in a fair, lawful, secure and transparent way. What personal data we hold on you You may give us information about you by filling in forms at an event or online, or by corresponding with us by phone, e-mail or otherwise. This includes information you provide when you register with the Club, or participate in discussion boards on our facebook groups and website. The information you give us may include your name, date of birth, address, e-mail address, phone number, name of the EA affiliated Clubs with which you are registered and gender (Athletics Data). Why we need your personal data The reason we need your Athletics Data is to be able to administer your membership, and provide the membership services you are signing up to when you register with the club. Our lawful basis for processing your personal is that we have a contractual obligation to you as a member to provide the services you are registering for. Reasons we need to process your data include: For training and competition entry • sharing personal data with leagues, and other competition providers for entry in events. For example PECO cross country. For membership and club management • processing of membership forms and payments; • sharing data with committee members to provide information about club activities, membership renewals or invitation to social events; • club newsletter promoting club activity; and • publishing of race and competition results The club has the following social media Facebook and Twitter. All members are free to join these pages. If you join one of the Social Media pages, please note that provider of the social media platform(s) have their own privacy policies and that the club do not accept any responsibility or liability for these policies. Please check these policies before you submit any personal data on the club social media pages. Who we share your personal data with When you become a member of the Club, you will also automatically be registered as a member of England Athletics Limited. We will provide England Athletics Limited with your Athletics Data which they will use to enable access to the MyAthletics portal. England Athletics Limited will contact you to invite you to sign into and update your MyAthletics portal. You can set and amend your privacy settings from the MyAthletics portal. If you have any questions about the continuing privacy of your personal data when it is shared with England Athletics Limited, please contact dataprotection@englandathletics.org. The Club does not supply any personal data it holds for this purpose to any other third party. The Club’s data processing may require your personal data to be transferred outside of the UK for the purpose of cloud hosting/storage. Where the Club does transfer your personal data overseas it is with the appropriate safeguards in place to ensure the security of that personal data. How long we hold your personal data We will hold your personal data on file for as long as you are a member with us. Athlete data is updated every year on annual membership forms. Any personal data we hold on you will be securely destroyed after four years of inactivity on that member’s account, in line with England Athletics Limited’s retention policy. Your data is not processed for any further purposes other than those detailed in this policy. Your rights regarding your personal data As a data subject you may have the right at any time to request access to, rectification or erasure of your personal data; to restrict or object to certain kinds of processing of your personal data, including direct marketing; to the portability of your personal data and to complain to the UK’s data protection supervisory authority, the Information Commissioner’s Office about the processing of your personal data. As a data subject you are not obliged to share your personal data with the Club. If you choose not to share your personal data with us we may not be able to register or administer your membership.

Declaration

By ticking this box, I confirm I have read and consent to the above Declaration and Privacy Notice

[recaptcha size:compact]